FAMILY GRANT APPLICATION

Friends of Chase Grant

Chasen’Tailz is dedicated to improving the lives of sick children in memory of Chase Warren. We understand how scary and isolating caring for a medically complex child can be. Our goal is to provide emotional & financial support during these times. We help pay living expenses, transportation, past due medical expenses, medication & therapies not covered by insurance and many others. Please complete the information below, by completing this application you authorize Chasentailz to share any donations received and photos.

FAMILY GRANT APPLICATION FORM

A copy of your current pay stub, W2 or Taxes may be required.